Background: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswith common bile duct calculus, dilated common bile duct, current attack of acute cholecystitis, those withabsolute contraindications to laparoscopic cholecystectomy, The data were collected prospectively to predictthe significance of association with patients’ characteristics. The time of operation was calculated from thefirst port site incision until the last port closure. All the intra operative events were recorded. Conversionsto open cholecystectomy were done by median or subcostal laparotomy according to the surgeon’s decisionand each patient’s condition. Results: In this study, the highest proportion of operations was categorizedas easy (58.3%), 28.3% of operations were considered difficult and 13.3% of them were very difficult. Asignificant association (P < 0.05) between operation difficulty and all of the following characteristics: Aging,obesity, history of previous biliary hospitalization, thickened bladder wall, pericholecystic collection, andlarge stones. Conclusions: The difficult laparoscopic cholecystectomy can be predicted preoperativelybased on number of factors, like: obesity, previous biliary admission, gall bladder wall thickness, ultrasoundfindings (stone size and pericholecystic fluid) and aging process, evaluating of such factors minimize thecomplications of laparoscopic cholecystectomy and conversion to the open procedure.
Most of the world is seeking attention to the agricultural sector, which occupies a distinguished economic center, including Iraq, it is no wonder that the focus is on this sector, especially in developing countries. Descriptive analysis of the sample tables of wheat and barley crops in Iraq showed that adherence to the principles and rules of total quality, including modern irrigation methods (irrigated) has a significant impact in increasing productivity, reducing costs and improving quality compared to traditional irrigation methods, so it became necessary to take agricultural economic units All procedures and means that will help in the application of the rules of total quality to promote the reality of wheat and barley cultivation in I
... Show MoreNinety nine swabs were collected from patients with diabetic foot ulcers (DFU), all swabs were cultured on different selective media for screening, 46 isolates confirmed as S. aureus by API staph. The results of antibiotic susceptibility test revealed that all isolates were resistant to metronidazole, 34 isolates were resistant to cefoxitin, ceftriaxone, and meropenim, 23 isolates were resistant to ciprofloxacin and norfloxacin, 17 and 16 isolates were resistant to tetracycline and trimethoprim, respectively; while all isolates were sensitive to tigecycline. The results of minimum inhibitory concentration (MIC) that carried out by using vancomycin, tigecycline and linezolid for 8 isolates, MIC results were1-2 µg /ml
... Show MoreThree isolates of P. aeruginosa were isolated from burnt patients. The ability of these isolates for adhesion and formation of slime layer were tested, the result showed that all isolates were able to adherence on the smooth surface. The sensitivity of P. aeruginosa isolates for antibiotics were tested , all isolates were sensitive to Gentamycin, Piperacillin and Amikacin Ciprofloxacin, and resist to Tetracyclin, Amoxicillin, Cephalexine , Ceftriaxone. Ciprofloxacin and Amikacin were found effective against P. aeruginosa isolates with MIC values of 3.8 μg/ ml for Ciprofloxacin and 0.244 μg/ ml for Amikacin The antibacterial effect of Different concentrations of Aloe
... Show MoreHepatitis B virus (HBV) infection is a significant global health problem. Populations of different ethnicities show great heterogeneity in HBV genotype frequency distributions. A cross-sectional study was conducted during June–October 2018 to determine frequency of HBV genotypes among chronic HBV patients from Baghdad, Iraq. The method of detection was nested polymerase chain reaction system. Further, the study assessed the impact of HBV genotypes on serum level of liver-function tests: total serum bilirubin, alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase. Eighty chronic HBV patients were enrolled in the study. Six HBV genotypes were identified (A, B, C, D, E and F). The most frequently encountered genotypes
... Show MoreThe tax exemption, whether wholly or partially, and for an unlimited duration of the investment or for a limited period of few years, is one of the encouraging things to the flow of foreign capital. And if necessary, impose tax on the profits of the invested capital, the promotion requires that not be discriminatory taxes or payments in the amount of money with the need to avoid double taxation. The tax exemption is granted by the government and the feature according to the law of a natural person or legal entity seeking from the government purports to achieve a set of political goals, economic and social development. The reduction of taxes or grants partial exemption is one of the factors that encourage attract of direct foreign i
... Show MoreThe current research aims to focus on strategic vigilance dimensions and contained (environmental vigilance, technological vigilance, competitive vigilance, vigilance marketing) to improve nursing services, which include a) the quality, timeliness, problem-solving and decision-making, relationships with others, leadership skills) and measure the degree link and influence between strategic vigilance in the hospital respondent and improve nursing service that the problem of the research lies in the weakness of strategic plans and health organizations in general and the hospital surveyed (martyr Ghazi al-Hariri), in particular, the lack of awareness of the hospital researched strategy vigilant management to improve nursing services,
... Show MoreThe research aims to shed light on the ethics of information systems and their role in achieving banking excellence for a sample of private banks in the province of Baghdad. It is important to focus on studying the ethics of banking information systems, which has become one of the most important basic and strategic resources that banks rely on to achieve outstanding performance. Achieving banking leadership in the Iraqi banking market. The researchers adopted the descriptive analytical approach to the research, and the questionnaire was considered as a main tool for collecting information in addition to personal interviews. The research reached the most important results that there is an acceptable correlation relationship between the ethic
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